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Upper Back Pain Overview

by Jaydee Vykoukal, PT, DPT October 30, 2019 0 Comments

Woman holding on her left shoulder

Upper back pain can be severe enough to keep you from being active and enjoying time with family and friends. A back injury can have a major impact on your life and work, but the sooner you pursue treatment, the easier it will be to achieve a full recovery. Keep reading to learn what causes chronic upper back pain, what symptoms to watch out for, and how to treat your pain so you can get back to your life.

Understanding Pain in Upper Back

The upper back, medically known as thoracic spine, is controlled by the thoracic region of the spinal cord, as well as the thoracic spinal nerves leading to it. Twelve vertebrae make up the thoracic spine, and each is attached to a rib. This creates a cage, which protects the vital organs. Upper back pain can develop anywhere from the base of the neck to the bottom of the ribcage. If a nerve in this area is injured, irritated, or pinched, you may feel pain in other areas where the nerve travels, such as your arms, belly, trunk, and chest.

One-sided upper back pain is common, as well. Most commonly, sufferers of right upper back pain are sedentary, right-handed people. Those with upper left back pain, on the other hand, are typically left-handed. Chronic upper back pain, when neglected, can become a very serious problem. Talk to your doctor to determine the best course of action.


Knowing the underlying cause of your upper back pain is important to developing a safe and effective treatment plan. Here are common root causes of upper back pain.

  • Improper Lifting

    Poor lifting technique when picking up something heavy leads to injury and pain.

  • Poor Posture

    Over time, sitting or standing with a rounded back and with shoulders hunched forward results in pain and stiffness. This is because poor posture places your ligaments, muscles, discs, and nerves under too much stress. Ultimately it creates an imbalance, with some areas being over-stretched while others are short and stiff.

  • Trauma or Injury

    Traumatic accidents or sudden injuries, such as a car crash, can cause long-term upper back pain. Sometimes the vertebra is fractured or is pressing on a spinal nerve.

  • Infection

    A paraspinal abscess or a spinal epidural abscess can compress the spinal nerves or spinal cord in the upper back, causing discomfort and other symptoms.

  • Osteoporosis

    This is a serious condition that weakens the bones and makes them prone to fractures. If you have osteoporosis, there is a high risk that you will develop upper back pain.

  • Joint Dysfunction

    Your ribs connect to the vertebrae by joints on either side of the thoracic spine. Issues in these joints may lead to upper back pain. The vertebrae connect to form two joints above and below each level in addition to the area that creates a disc joint. These are all potential areas of pain as well.

Symptoms of Upper Back Pain

When there is damage to the muscles in the upper back, the immune system immediately releases inflammatory molecules that result in discomfort. This pain alerts you that something is wrong and motivates you to seek treatment and recovery. Symptoms associated with upper back pain may include:

  • Sharp pain in upper back when taking a deep breath
  • Stiffness
  • Headaches
  • Muscle spasms
  • Tenderness
  • Tingling or numbness in your inner arms or trunk
  • Generalized weakness in your arms
  • A dull, aching pain that tends to get better with a change in position or rest

Diagnosing Upper Back Pain

When you visit your doctor to address your constant upper back pain, he or she will take several steps to accurately diagnose the cause of your discomfort.

  • Physical Examination

    After discussing your medical history and your current symptoms, your doctor will conduct a thorough physical examination, observing your posture, physical condition, and range of motion. Your doctor will also examine your spine, evaluate its alignment and curvature, and feel for tenderness and muscle spasms.

  • CT Scan

    A CT scan produces clear images of joints and bones, which will help your doctor verify the extent of the damage. However, keep in mind that there is little correlation between your symptoms and what may be found on an imaging scan.

  • MRI Scan

    If your doctor suspects a nerve problem, you may need an MRI scan, which shows detailed pictures of spinal structures. It can help rule out more serious issues such as infection or cancer too.

  • BMD Test

    You will need a bone mineral density (BMD) test if your doctor suspects you have osteoporosis. This diagnostic procedure, which only takes five to ten minutes, will help your doctor determine the health and strength of your bones.

  • Neurological Exam

    You may need to undergo a neurological exam to test your muscle strength, nerve changes, reflexes, and pain spread. A neurological exam also determines whether your spinal nerves have been affected, and even which specific ones.

Recovering from Upper Back Pain

Chronic upper back pain is not as common as neck or lower back pain, but it can still have a big impact on your quality of life. Work with your doctor and follow their instructions to develop a safe and effective treatment plan that includes a variety of the following.

Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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